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Abstract
The incidence of candidemia in the overall population ranges from 1.7 to 10 episodes
per 100,000 inhabitants and Candida is one of the ten leading causes of bloodstream
infections in developed countries. An estimated 33-55% of all episodes of candidemia
occur in intensive care units (ICU) and are associated with mortality rates ranging
from 5% to 71%. Candida fungemia may have an endogenous or an exogenous origin, and
in recent years a growing proportion of episodes of candidemia have been caused by
Candida species other than albicans. The most important independent conditions predisposing
to candidemia in ICU patients include prior abdominal surgery, intravascular catheters,
acute renal failure, parenteral nutrition, broad-spectrum antibiotics, a prolonged
ICU stay, the use of corticosteroids and mucosal colonization with Candida. In recent
years, several studies have shown that ICU patients with mucosal Candida colonization,
particularly if multifocal, are at a higher risk for invasive candidiasis, and that
colonization selects a population amenable to antifungal prophylaxis or empirical
therapy. Candidemia in ICUs is associated with a considerable increase in hospital
costs and length of hospital stay.